Nova Scotia Premises Identification Program

Transcription

1 Nova Scotia Premises Identification Program Premises identification links livestock and poultry to identifiable geographic locations for the purpose of emergency planning and management. Over time, the national traceability system is expected to include all livestock and poultry species. The current priority is to have all farms and ranches producing cattle, hogs, sheep, goats, bison, cervids and poultry entered into the Nova Scotia PID program. It is recommended that owners of other livestock species also apply for premises identification numbers and be entered into the program. A premises identification number is a unique alpha-numeric identifier assigned to a parcel of land on which animals are bred, kept, raised, displayed, assembled or disposed of. Premises identification is one of the three pillars of a full traceability system. The other two pillars are animal identification and animal movement reporting. Together, the three pillars enable the tracking of locations where animals have been located and the identification of any other animals with which they have been in contact. Instructions: 1. Complete the application form to setup a new PID account or update an existing PID account in the Nova Scotia Premises ID Program; and 2. Complete, sign and date the Consent to Disclose Personal Information Form Submit completed forms to: Nova Scotia Department of Agriculture PID Program P.O. Box College Road Truro, Nova Scotia, B2N 5G6 Fax: NSPID@gov.ns.ca For further information, please NSPID@gov.ns.ca or visit 1 of 5

2 Agriculture Nova Scotia Premises Identification Program Application Forms Purpose of application: New Applicant Update an Existing PID Account Current PID: I currently have livestock and/or poultry at this location Emergency Contact Information (Individual responsible for care and control of animals) First Name: Middle Name: Last Name: Business/Farm Name: Mailing Address: Town/City: County: Postal Code: Business Phone: Cell Phone: Fax: Home Phone: Relationship of emergency contact to premises (select one): Owner Lessee Operator Renter Other (specify): Land Owner Information (Complete if different than the Emergency Contact) First Name: Middle Name: Last Name: Business/Farm Name: Mailing Address: Town/City: County: Postal Code: Business Phone: Cell Phone: Fax: Home Phone: of 5 APRIL

3 Premises Location Property Identification Number (found on your property tax bill): Property Civic Address: Town/City: County: Geo-Referenced Coordinates (if available and in decimal degrees): Latitude: +. Longitude: -. Location referenced by coordinates (e.g. driveway, barn, etc.) Name or description of premises (e.g. home yard, community pasture, corrals, main barn, etc.) Additional Locations If you have additional locations used solely for pasturing animals, please list the Property Identification numbers (found on your property tax bill).,,,,,, Premises Type (select all that apply) Farm Assembly Yard Embryo Transfer Facility Hobby Farm/Small Acreage Auction Market/Livestock Sale Facility Research Facility Stable/Horse Boarding Facility Racetrack Egg Grading Station Feedlot Exhibition/Fairground Poultry Sales Facility Pasture Competition Facility Hatchery Community Pasture Provincial Abattoir Petting Farm/Zoo Veterinary Clinic/Hospital/Lab Federal Abattoir Rendering Plant Carcass/Deadstock Disposal Site Insemination Unit Meat Processing/Storage Other 3 of 5

4 Species Type (select all that apply) Species Max. Capacity Species Max. Capacity Cattle: Beef Cattle: Dairy Bison Swine Wild Boar Sheep Goats Llamas, Alpacas, Vicuna Horses Donkeys, mules Cervids Mink Fox Farmed Rabbits Farmed Chinchillas Wildlife Specify Broiler Breeder Pullets Broiler Breeder Layers Broiler Chickens Layers - Breeders Layers Pullets Layer Chickens Turkeys Breeder Turkeys Meat Other Birds Specify Purebred/Fancier Flock Bees (hives) Aquaculture Crustaceans Aquaculture Molluscs Aquaculture Salmon Aquaculture Other fish Other Specify 4 of 5

5 Consent to Disclose Personal Information Form Your written consent authorizes the Nova Scotia Department of Agriculture to disclose your personal information to a designated individual or agency in accordance with the Nova Scotia Freedom of Information and Protection of Privacy Act. Use and/or Disclosure The personal information is being collected under the authority of the Department of Agriculture and may be used by the Department of Agriculture, or disclosed to a designated individual or agency, for the purpose of preventing, preparing for, responding to or recovering from federally and provincially-reportable animal diseases, diseases of significance to animal or public health, natural disaster emergencies and other disasters; or to verify the accuracy of information held in the Nova Scotia Premises Identification Program. Consent I,, authorize the Nova Scotia Department of Agriculture to disclose information, including my personal information*, contained in my Premises Identification Program Application Form to the Canadian Food Inspection Agency, the Chief Veterinary Officer of Canada, Provincial Chief Veterinary Officers across Canada, and other Departments, Agencies and Commissions of the Government of Nova Scotia. Name (please print) Signature Date (yyyy-mm-dd) *I will provide the necessary updates within 30 days of any change to ensure that the information related to the premises in this Application Form and attached schedules is complete and correct. Submit completed forms to: Nova Scotia Department of Agriculture PID Program P.O. Box College Road Truro, Nova Scotia, B2N 5G6 Questions? Call Fax: NSPID@gov.ns.ca Website: 5 of 5